Better sleep for shift workers
Excerpt taken from: ‘Healthy sleep practices for shift workers: consensus sleep hygiene guidelines using a Delphi methodology’, published in Sleep in 2023
Introduction
As a shift worker, it can be difficult to get enough good quality sleep, which can impact health, wellbeing, job performance, and safety.
These guidelines provide shift workers with advice on healthy sleep practices, which can improve sleep during rostered periods of work. They are based on scientific evidence and offer strategies that will work for most people. It is important to remember that everyone is different. Please use them as a guide, and incorporate them based on your shift schedule, lifestyle, commitments, etc.
If you have any concerns or queries about your sleep or managing the effects of shift work, it’s important to seek advice from a health professional. Your GP/primary care provider is a good place to start, while sleep physicians and sleep psychologists can help with tailored treatments.
Guideline 1. Prioritise your sleep
As a shift worker, it can be difficult to get enough sleep. Make sleep a priority by rescheduling social activities and household tasks where possible, and informing friends, family, and neighbours of your sleep schedule.
Guideline 2. Aim for 7–9 hours of sleep per 24 hours
Your individual sleep needs may differ, but research shows that 7–9 hours is the amount of sleep most healthy adults require. This may be achieved as one single sleep period, or as a main sleep supplemented by a shorter sleep(s). Keep in mind that this is total time spent asleep, not just time in bed.
Guideline 3. Develop a sleep schedule
Your sleep schedule should be based on your roster and lifestyle. Try to maintain a similar sleep schedule for each shift type (e.g. Bedtime A for day shifts, Bedtime B for afternoon shifts, etc.), remembering to allow a sufficient opportunity for sleep (i.e. 7–9 hours total over 24 hours).
Guideline 4. Develop a bedtime routine
Find activities that help you wind-down and feel relaxed, and consistently engage in these activities before bed, ideally in a dimly lit and quiet environment. This is particularly beneficial if you have trouble falling asleep.
Guideline 5. Plan your transition to days off*
When transitioning to a block of days off, particularly after working late/night shifts, one strategy that may work for you is to have a short sleep in the morning and go back to bed earlier than your usual bedtime. Some sunlight after waking in the morning can help your body clock realign to the day-night cycle.
Guideline 6. Use napping as a helpful tool
Short naps (15–20 minutes) can boost alertness and performance, while longer naps (90 minutes) can reduce sleep debt. Naps less than 15 minutes may be too short to be beneficial, while naps longer than 20 minutes may make you more likely to experience sleep inertia (see guideline 7). Keep in mind that longer naps should be avoided in the 4–6 hours before your main sleep as they may make it more difficult to fall asleep. Ideally, nap in a quiet, dark, and cool environment for best sleep quality.
Guideline 7. Consider sleep inertia
After waking, shift workers may experience sleep inertia - a period of grogginess, where alertness and performance are impaired. This feeling typically lasts 15–30 minutes after waking but can last up to 2 hours. It is important to avoid high-risk tasks (e.g. driving, operating machinery) during this time.
Guideline 8. Create a comfortable sleep environment
Aim to sleep somewhere that is: Comfortably cool: 16–20ºC/ 60–68ºF with adequate ventilation. Dark: block out as much light as possible (e.g. use appropriate window furnishings, wear an eye mask).Quiet: block out as much noise as possible (e.g. close doors and windows, use ear plugs, switch off devices). Some people find white noise helpful.
Guideline 9. Use your bed for sleep and intimacy
Use your bed for sleeping and intimacy only, if possible. Avoid mentally stimulating activities in bed (e.g. playing video games, working on a laptop), and be mindful of sharing your bed with others (e.g. pets) who may disturb your sleep.
Guideline 10. Consider light exposure
Exposure to bright light before bed can impact your sleep. Try to limit exposure where possible, for example, by wearing sunglasses while driving home after night shift, or by turning down screen brightness on devices.
Guideline 11. Consider caffeine intake
Caffeine can help to improve alertness and performance before and during your shift. However, the effects of caffeine can last for several hours, often longer than you think, and vary greatly between people. Keep in mind that caffeine too close to your bedtime may impact your sleep.
Guideline 12. Consider nicotine consumption
Avoid nicotine entirely, or limit nicotine intake in the 6 hours before bed.
Guideline 13. Consider alcohol intake
Avoid alcohol as part of your bedtime routine. Some people feel that alcohol helps them fall asleep. However, drinking alcohol close to bedtime, even in small amounts, negatively impacts your sleep quality.
Guideline 14. Be mindful of medication
Medications can impact sleep. Some medications have stimulant effects, and ideally, shouldn’t be taken near bedtime. Some natural substances, like melatonin, can be helpful for shift workers experiencing sleep problems. Sleep-inducing medications (i.e. sleeping tablets) should usually only be used for short-term or intermittent relief of sleep problems. Always consult a healthcare professional regarding medication use and its impact on your sleep.
Guideline 15. Consider food intake
Where possible, limit food intake during night shifts, and if you do eat, opt for smaller, lighter meals. Don’t go to bed hungry, as this may negatively impact sleep, but choose a lighter meal before bed that won’t cause indigestion or discomfort.
Guideline 16. Consider fluid intake
It’s important to maintain hydration by drinking plenty of water; however, avoid too much fluid before bed, as this may lead to sleep disturbances to use the toilet.
Guideline 17. Engage in regular exercise
Regular exercise is important for general health, and can help you sleep better, so it should be included around your shift schedule and lifestyle. Keep in mind that research now shows that night time exercise doesn’t disrupt sleep for most people; however, it’s also important to spend time winding down before bed.
Guideline 18. Develop strategies for sleep problems
If you’re unable to sleep, get out of bed and do something relaxing in a quiet, dimly lit environment. Try to limit screen time and clock-watching and go back to bed once you’re feeling sleepy. If sleep problems occur more than 3 times/week for several weeks in a row, seek advice from a healthcare professional.
Excerpt from the paper:
Alexandra E Shriane, Gabrielle Rigney, Sally A Ferguson, Yu Sun Bin, Grace E Vincent, Healthy sleep practices for shift workers: consensus sleep hygiene guidelines using a Delphi methodology, Sleep, 2023;, zsad182,
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